Elevated granulocyte colony-stimulating factor levels predict treatment failure in patients with Kawasaki disease.
BACKGROUND
Kawasaki disease (KD) is an acute vasculitis in young children, frequently associated with coronary artery aneurysms. The intravenous infusion of high-dose IgG (IVIG) effectively reduces the systemic inflammation and the incidence of coronary artery lesions, although the precise underlying mechanisms are unknown.


OBJECTIVE
We performed expression profiling of whole blood cells to investigate the mechanisms underlying the effect of IVIG and to identify biomarkers associated with unresponsiveness to IVIG.


METHODS
We compared the transcript abundance among pre-IVIG and post-IVIG patients and febrile control patients. Then we analyzed the mRNA levels and the protein levels among the different cohort of patients with KD who were either responsive or nonresponsive to the initial IVIG.


RESULTS
A total of 298 transcripts were overrepresented or underrepresented in the pre-IVIG patients compared with post-IVIG patients and febrile controls, of which 15 transcripts were differentially expressed in nonresponsive patients with KD compared with responsive patients before IVIG. The protein levels of polycythemia rubra vera 1, which was one of the most variably expressed transcripts in pre-IVIG patients, and the serum granulocyte colony-stimulating factor levels were significantly higher in nonresponsive patients than in responsive patients before the initial IVIG administration.


CONCLUSIONS
These findings suggest that the variable gene expression profiles were correlated to the responses of patients with KD to IVIG administration. Polycythemia rubra vera 1 and granulocyte colony-stimulating factor levels may be good biomarkers for predicting response to IVIG in patients with KD.
Abe
Jun
J
Department of Allergy and Immunology, National Research Institute for Child Health and Development, Tokyo, Japan. jabe@nch.go.jp
Ebata
Ryota
R
Jibiki
Toshiaki
T
Yasukawa
Kumi
K
Saito
Hirohisa
H
Terai
Masaru
M
D015415:Biomarkers / Q000097:blood; D002675:Child, Preschool; D005260:Female; D058851:GPI-Linked Proteins; D020869:Gene Expression Profiling; D016179:Granulocyte Colony-Stimulating Factor / Q000097:blood*; D006801:Humans; D007074:Immunoglobulin G / Q000008:administration & dosage; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage; D007223:Infant; D007519:Isoantigens / Q000097:blood; D008297:Male; D008562:Membrane Glycoproteins / Q000097:blood; D009080:Mucocutaneous Lymph Node Syndrome / Q000097:blood*; D011237:Predictive Value of Tests; D011956:Receptors, Cell Surface / Q000097:blood; D017211:Treatment Failure
D015415:Biomarkers; C407242:CD177 protein, human; D058851:GPI-Linked Proteins; D007074:Immunoglobulin G; D016756:Immunoglobulins, Intravenous; D007519:Isoantigens; D008562:Membrane Glycoproteins; D011956:Receptors, Cell Surface; D016179:Granulocyte Colony-Stimulating Factor